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IOS 10 Exam 2

Sulfonamides, rifampin, nitrofurantion, chloramphenicol

QuestionAnswer
Sulfonamides MOA They are analogue of PABA hich binds dihydropeteroate synthase which would normally catalyze the first step of dihydrofolic acid synthesis (purine, thymidine- DNA)
Trimethoprim MOA Structural analogue of duhydrofolic acid, it binds the dihydrofolate reductase and inhibits the concversion of dihydrofolate to tetrahydrofolate
Rifampin MOA Bacterialcidal binds to the B-subunit of RNA polymerase and inhibits the initation of transcription
Nitrofurantion MOA The AB is initially reduced to the ROS which interacts with DNA. At low concentrations it is a bacteriostatic at high it is a bacteriocidal
Chlorampenicol MOA Binds to the 50S ribosomal subunit. Bacteriostatic against most organisms but Bactericidal against S. pneumoniae, H. influ, N. meningitis
Resistance of Sulfonamides Intrinsic resistance (E. facalis, lactobacilli-auxotrophic for folic acid), aquired resistance via single chromosomal mutation or plasmid mediated, alterations in enzyme, or PABA
Resistance of trimethoprim Aquired resistance via chromosomal and plasmid mutation, decreased affinity of enzyme, hyperproduction of dihydrofolate, decrease porin permibility
Resistance of Rifampin Aquired mutation-single monotherapy lead to mutation of RNA polymerase B-subunit. ALWAYS USE COMBO DRUG
Resistance of nitrofurantion Aquired mutation causes reduced ROS generation or changes in permibility
Gram + aerobic activity of sulfonamides Acinomycetes, listeria, nocardia, mycobacteium, staph aureus, strep
Gram- aerobic activity of sulfonamides Burkholderia, enterobacteriae, heameophilus, neisseria, pseudomonas, stenotrophomonas
Anaerobic activity of sulfonamides bacteroides (not fragilis) Gardenerella
Atypical activity of Sulfonamides Chlaymidia, legionella
Protozian activity of sulfonamides Acanthamoeba, Pneumocystis, toxoplasma, plasmodium falciparum
Fungi activity of sulfonamides Histoplasma capsulatum, paracoccidodes brasilensis
Gram + aerobe activity of Rifampin Strep A, B, C, G, pneumonia,MSSA, MRSA, Coag(-),ornybacterium, listeria
anaerobic activity of rifampin NONE
Gram - aerobe activity of rifampin N. gonorrheae, meningitis, M. cararrhalis, H. influenza, F. tularensis, Brucella, bartonella henselae,
Atypical activity of rifampin Chlamydia, mycobacterium, leginella, Teberculosis,
Gram + aerobic activity of nitrofurantion Strep A, V, C, G, and pneumonia, MSSA, enterococcus
Gram - aerobic activity of nitrofurantion N. gonorrhoeae, E. coli, klebsiella, enterobacter, salmonella, shigella
Anerobic activity of nitrofurantion NONE
Gram + aerobic activity of Chloramphenicol Strep A, B, C, G, penumonia,MSSA, MRSA (some), enterococci, bacillus anthracis
Gram + anaerobic Actinomycetes, Clostridium, peptostreptococcus
Gram - aerobes activity of chloramphenicol Haemophilus, moraxella, aeromonas, salmonella, shiegella, e. coli, klebsiella, proteus, neisseria, vibria, brucella, yersina, pseudomonias (not aurginosa)
Gram - anaerobes activity of chloramphenicol Bacteroides, provotella
Sulfonamides short to medium activity Rapid absorption and elimination t1/2 11 hours
Long acting sulfonamides Only Silfathoxine used t1/2 100-200 hrs treatment for P. falcioarum
Topical sulfonamides Suldacetamide used in opthalamic and solutions
Slufamethoxazole and trimethoprim clinical use UTI, STD, FIRST LINE pneumonia, enteric infections
Rifampin clinical used Mycobacterial infections (pulmonary TB), Meningitis prophylaxis, Endocarditis, Meningitis
Nitrofurantion clinical use Uncomplicated UTI
Chloramphenicol clinical use Rarely used due to aplasic anemia which is not reversible!!!!
Created by: liza001